How much does Medicare pay for CPT 88305?

Medicare allowed an average of $50.75 per service and paid $38.57 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $186.04, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88305?

Pathology examination of tissue using a microscope, intermediate complexity. It was billed 18,351,551 times to 9,188,800 Medicare beneficiaries by 14,573 providers in 2024.

Does 88305 pay differently in an office than a hospital?

Yes. The allowed amount averaged $57.95 in an office setting and $35.99 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 88305 most?

Pathology, with 11,269,038 services from 10,984 clinicians. Next are Clinical Laboratory, Dermatology, Gastroenterology.

CPT 88305

Pathology examination of tissue using a microscope, intermediate complexity

$50.75Medicare-allowed amount per service, averaged across 18,351,551 services

Providers submitted

$186.04

Asking price, not received

Medicare allowed

$50.75

The fee schedule figure

Medicare paid

$38.57

Balance is patient coinsurance

Providers submitted an average of $186.04 for this code and Medicare allowed $50.75 — 3.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $38.57 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $57.95
Hospital / facility: $35.99

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 12,338,222 services were billed in an office setting and 6,013,329 in a facility.

Services: 18,351,551
Beneficiaries: 9,188,800
Providers billing it: 14,573
Total allowed: $931,341,213

What Medicare pays for CPT 88305

Across 18,351,551 services billed by 14,573 providers to 9,188,800 beneficiaries, Medicare allowed an average of $50.75 per service. That is 2.0 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 88305

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	11,269,038	5,724,355	$48.35	10,984
Clinical Laboratory	4,044,263	1,929,770	$55.92	512
Dermatology	2,468,394	1,288,377	$55.41	1,640
Gastroenterology	348,603	128,334	$38.61	899
Slide Preparation Facility	41,437	19,617	$42.25	8
Micrographic Dermatologic Surgery	38,763	21,186	$51.42	39
Internal Medicine	25,548	10,043	$43.14	84
Physician Assistant	17,194	10,481	$37.60	94
All Other Suppliers	16,455	8,074	$41.51	1
Oral Surgery (Dentist only)	10,287	8,577	$59.00	36
Nurse Practitioner	10,089	5,825	$35.69	33
Podiatry	8,658	2,963	$69.41	16
Diagnostic Radiology	7,753	3,778	$35.46	5
Family Practice	6,767	3,968	$51.82	44
Dentist	5,797	4,629	$49.39	16

88305 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	2,036,321	$53.32	$40.90	993
California	1,885,160	$55.62	$37.81	1,608
Texas	1,465,971	$51.68	$39.17	1,144
New York	1,267,459	$59.14	$40.54	991
Pennsylvania	829,061	$51.30	$37.98	591
Massachusetts	693,431	$51.23	$35.36	512
Illinois	628,992	$45.18	$33.82	597
Ohio	606,552	$47.65	$37.63	548
Tennessee	585,629	$49.07	$39.04	394
Georgia	584,185	$56.05	$42.40	338
North Carolina	572,998	$52.16	$40.90	438
New Jersey	492,166	$50.85	$35.78	290
Arizona	488,052	$53.55	$41.04	279
Maryland	419,621	$56.36	$39.06	282
Wisconsin	410,266	$48.26	$36.58	286
Virginia	383,301	$48.82	$36.84	250
Washington	349,751	$52.19	$36.42	330
South Carolina	339,752	$43.09	$34.56	224
Alabama	289,661	$54.01	$43.93	168
Michigan	288,604	$44.43	$33.86	462
Indiana	276,441	$42.83	$33.48	230
Minnesota	259,286	$41.99	$30.95	513
Arkansas	256,453	$43.55	$35.75	172
Missouri	255,497	$45.16	$35.14	286
Colorado	247,133	$47.65	$34.39	232
Connecticut	218,307	$53.79	$38.82	208
Kansas	192,146	$43.27	$34.12	125
Kentucky	176,012	$42.43	$33.49	175
Iowa	169,623	$42.61	$33.26	135
Oregon	165,395	$44.35	$32.38	273
Louisiana	157,851	$35.67	$28.64	218
Oklahoma	124,987	$44.17	$35.02	104
Mississippi	123,330	$45.50	$36.90	83
Nevada	123,127	$50.20	$39.07	75
New Hampshire	113,570	$45.42	$33.47	66
Nebraska	109,011	$42.31	$32.63	96
Utah	107,849	$48.08	$37.27	157
South Dakota	77,745	$36.13	$26.77	55
North Dakota	65,603	$38.88	$28.62	40
New Mexico	59,363	$43.21	$33.71	64
West Virginia	59,351	$43.31	$33.65	77
Maine	59,127	$41.84	$30.04	62
Montana	56,555	$39.78	$30.45	30
Delaware	45,154	$49.13	$37.60	39
Idaho	41,714	$52.11	$41.51	31
Hawaii	41,560	$56.07	$39.39	48
District of Columbia	35,207	$41.38	$29.62	47
Rhode Island	33,267	$40.19	$29.56	65
Vermont	33,039	$37.12	$27.00	45
Wyoming	18,494	$54.71	$39.74	15
Alaska	17,748	$45.55	$27.90	18
Puerto Rico	11,880	$62.48	$46.29	56
ZZ	1,187	$36.12	$27.29	5
Guam	746	$37.84	$27.64	1
AP	676	$51.74	$38.23	1
AE	184	$38.43	$27.90	1

Related codes

88341Special stained specimen slides to examine tissue$40.33
88342Special stained specimen slides to examine tissue$58.61
88313Special stained specimen slides to examine tissue including interpreta$43.56
88312Special stained specimen slides to identify organisms including interp$75.82
88307Pathology examination of tissue$84.93
88304Pathology examination of tissue$21.25
88360Microscopic genetic analysis of tumor$59.67
88311Preparation of tissue for examination by removing any calcium present$12.68
88331Pathology examination of specimen during surgery$72.30
88350Antibody evaluation$59.99
88344Special stained specimen slides to examine tissue$100.56
88374Microscopic genetic analysis of tissue$108.04

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.